European Child & Adolescent Psychiatry

, Volume 26, Issue 8, pp 957–967 | Cite as

Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study

  • Hermann PohlabelnEmail author
  • Stefan Rach
  • Stefaan De Henauw
  • Gabriele Eiben
  • Wencke Gwozdz
  • Charalampos Hadjigeorgiou
  • Dénes Molnár
  • Luis A. Moreno
  • Paola Russo
  • Toomas Veidebaum
  • Iris Pigeot
  • On behalf of the IDEFICS consortium
Original Contribution


The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child’s risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2–11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child’s risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3–4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09–3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05–4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91–3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.


Attention-deficit/hyperactivity disorders European children cohort Gestational hypertension Maternal age Neonatal respiratory disorders Smoking 



This work was done as part of the IDEFICS study ( We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD) and the grant support from EU for IDEFICS study. We thank the children and their parents for their participation in the IDEFICS study. Finally, we would also like to thank the anonymous reviewers for their helpful comments and suggestions, which we have addressed in the revised manuscript.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Hermann Pohlabeln
    • 1
    Email author
  • Stefan Rach
    • 1
  • Stefaan De Henauw
    • 2
  • Gabriele Eiben
    • 3
  • Wencke Gwozdz
    • 4
  • Charalampos Hadjigeorgiou
    • 5
  • Dénes Molnár
    • 6
  • Luis A. Moreno
    • 7
  • Paola Russo
    • 8
  • Toomas Veidebaum
    • 9
  • Iris Pigeot
    • 1
  • On behalf of the IDEFICS consortium
  1. 1.Leibniz Institute for Prevention Research and Epidemiology—BIPSBremenGermany
  2. 2.Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
  3. 3.Section for Epidemiology and Social Medicine, Institute of MedicineSahlgrenska Academy, University of GothenburgGothenburgSweden
  4. 4.Department of Intercultural Communication and Management, Centre for Corporate Social ResponsibilityCopenhagen Business SchoolCopenhagenDenmark
  5. 5.Research and Education Institute of Child HealthStrovolosCyprus
  6. 6.Department of Paediatrics, Medical FacultyUniversity of PécsPecsHungary
  7. 7.GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn)University of ZaragozaSaragossaSpain
  8. 8.Unit of Epidemiology & Population Genetics, Institute of Food SciencesNational Research CouncilAvellinoItaly
  9. 9.National Institute for Health DevelopmentTallinnEstonia

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